Shoulder Pain And Back Pain Treatment

The rotator cuff are the group of muscles that surround the shoulder and help to keep it stable and strong during movement.

These muscles can often become a source of pain - either due to inflammation or to tearing in the muscle fibres or in the muscle tendons that join the muscles to the bone.

Recovery from rotator cuff pain can be a long process - and you may receive a bewildering range of advice along the way.

Check out this great Guide to Rotator Cuff Injury - written by tennis pro Brent Abel. It's a comprehensive overview of the nature of the problem and of the available treatments.

Labels: joint pain, muscle injury, shoulder pain

Shoulder replacement surgery is not a new option for patients with severe pain due to shoulder arthritis - but there is an intriguing new approach available which seems to be yielding great results.

Surgeons are putting in the new shoulder joint "in reverse"

With the new reverse shoulder prosthesis, the classic ball-and-socket shape of the joint is basically reversed.


The shoulder is made up of a ball and socket joint and a rotator cuff. The ball connects to the arm, the socket connects to the shoulder blade. The rotator cuff is muscle that surrounds the joint and helps lift and rotate the arm. But in patients suffering from a torn rotator cuff or arthritis, this protection is gone and bone painfully scrapes against bone.

Now a new procedure can help.

Instead of the ball being on the arm side, now we see a socket on the arm side, and the ball is actually on the shoulder side, or the socket side. What the reverse prosthesis does it allows us to stabilize the shoulder, normalize the center of rotation, thus improving function and relieving pain.

The surgery takes about 90 minutes and usually leads to a full recovery in around four months.


Surgeons in Europe have been performing RSP, or reverse shoulder procedure surgery, for 15 years with excellent results. Now the FDA has approved the surgery, but it still will take a while for it to catch on across the country.

Read more about Reverse Shoulder Surgery here

Labels: arthritis, pain control, shoulder pain, surgery

A new review of the evidence has been undertaken to assess whether those with frozen shoulder or adhesive capsulitis might benefit from a short course of oral steroid tablets.

The studies tested people who had adhesive capsulitis for about 6 months.

They were given no treatment, fake treatments, steroid injections or oral steroids.

Oral steroids, such as prednisolone or cortisone were given for about 3 to 4 weeks, and sometimes again for another 3 to 4 weeks if people still had pain and stiffness. All people had physiotherapy or an exercise programme while taking the steroids.


Benefits of oral steroids for adhesive capsulitis or frozen shoulder

In people with adhesive capsulitis, at 3 weeks, oral steroids may work more than fake pills:

• 48 out of 100 people who took fake pills said they were better
  
  ­96 out of 100 people who took steroids said they were better

Oral Steroids may decrease pain and disability more than fake pills ­- the studies show that pain may decrease by 2.7 more points on a scale of 0 to 10 with steroids

­Researchers also found that disability may decrease by 18 more points on a scale of 0 to 100 with steroids and that oral steroid tablets may increase the ability to move the shoulder more than fake pills - ­shoulder movement increased by 23 degrees

But these benefits did not last as long as 6 weeks so there is not enough evidence to be certain of the results beyond 3 weeks.

Oral steroids may also improve pain earlier and quicker than no treatment at all. But after 5 months there were no benefits of oral steroids over no treatment. There is also not enough evidence to be certain of the results.

Harms of oral steroids
In people with adhesive capsulitis who have no serious other problems, taking oral steroids for a short time may not cause serious side effects. But there is not enough evidence to be certain. Other research about steroids taken over longer periods of time shows that harms could include high cholesterol and high blood pressure.

Read more about frozen shoulder treatment

Labels: frozen shoulder, shoulder pain, steroid treatment

Psychological treatments such as cognitive behavior therapy, hypnosis, counseling and relaxation can improve pain and quality of life for those who have chronic back pain.

Chronic back pain is very common and sometimes it is hard to treat. Painkillers and surgery may help but, according to a new review, psychological treatments may also be effective.

A team at the VA Connecticut Healthcare System looked at 22 trials done between 1982 and 2003. These included patients who had had back pain for at least three months. In many cases, they had been in pain for several years.

The studies included the use of cognitive behavior therapy, hypnosis, counseling and relaxation. The researchers looked at 12 pain-related outcomes including pain intensity, depression, disability and quality of life.

They concluded that psychological interventions, either alone or as part of a multidisciplinary approach, were superior to other approaches on the whole range of pain-related outcomes. The best results were on back pain intensity. This is surprising, as the psychological approach was originally developed to help people live with their back pain rather than to reduce it.

Psychological treatments also tend to be more cost-effective for back pain than approaches such as surgery or drug treatments

Many back pain sufferers tend to shy away from any mention of psychology or psychological based treatment - but, if you suffer from chronic back pain, you really should give these methods some serious consideration

You can read more about this here

People plagued by chronic lower back pain may find some relief in yoga class, researchers reported.

Their study of 101 adults with persistent low back pain found that a gentle yoga class seemed to be a better alternative to either general exercise or a self-help book. Though people in the exercise class eventually improved to a similar degree as their yoga-practicing counterparts, yoga class brought quicker results.

It seems possible that yoga's benefits for both the body and mind explain the effects on lower back pain.

The study participants took a slower-moving form of yoga that was designed for people with lower back problems. Vigorous styles of yoga that include more-advanced poses could potentially make chronic back pain worse.

The Group Health Cooperative in Seattle report the findings in the Annals of Internal Medicine this week.

It's estimated that 14 million Americans practice yoga, often as a way to treat chronic aches and pains. But, in the Western medical literature at least, there have been no previous published studies on the effects of yoga on chronic back pain

Read more here